Kelly Ellen Pestey, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

002122 Issued in CT

Practice address

42 Prospect St
Manchester, CT 06040-5802

Phone

(860) 645-1255

NPI assigned

Nov 27, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637971200000",
    "number": "1487311304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 TOBACCO ST",
            "city": "LEBANON",
            "state": "CT",
            "postal_code": "062491632",
            "telephone_number": "860-608-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 PROSPECT ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405802",
            "telephone_number": "860-645-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESTEY",
        "first_name": "KELLY",
        "middle_name": "ELLEN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-27",
        "last_updated": "2021-11-27",
        "certification_date": "2021-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "002122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy Lynn Neron Perry, LMT
• Shirley Marie Perry
• Aidan A Persaud
• Toscha M. Pertillar, MSW
• Trisha Lyn Pesce, M.D.
• Stephen M. Peszynski, DPT
• Daniel E. Petashnick, M.D.
• Briana Marie Peterson, PA-C
• Trey M Peterson
• Samantha Petillo, PHARMD

• Occupational Therapy Assistant in Manchester, CT
• Providers in Manchester, CT by specialty
• Occupational Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.